Department of Obstetrics and Gynecology, University Hospital of Amiens, CHU Amiens-Picardie, Avenue Laennec, 80054 Amiens Cedex 1, France.
Department of Obstetrics and Gynecology, University Hospital of Amiens, CHU Amiens-Picardie, Avenue Laennec, 80054 Amiens Cedex 1, France.
J Gynecol Obstet Hum Reprod. 2020 Apr;49(4):101693. doi: 10.1016/j.jogoh.2020.101693. Epub 2020 Jan 21.
External cephalic version (ECV) is a procedure during which the fetus is rotated from breech or transversal to cephalic presentation. Our aim was to assess the outcomes of successful ECV in terms of obstetrical and immediate neonatal outcomes relative spontaneous cephalic presentation.
We performed a retrospective single-center observational study from January 2007 to December 2017. All included participants benefited from trial of labor with delivery of the fetus in cephalic presentation. They were divided into two groups depending on whether an ECV had been successfully performed or cephalic presentation was spontaneous.
The cephalic presentation after ECV and spontaneous cephalic groups comprised 55 and 244 patients, respectively. The two groups differed significantly in terms of the proportion of induced labor (20 [36.4 %] and 56 [22.9 %], p = 0.04), use of oxytocin during labor (31 [56.4 %] and 100 [49.9 %], p = 0.04), duration of labor (342 ± 183 min and 279 ± 140 min, p = 0.008), spontaneous delivery (38 [69.1 %] and 199 [81.5 %], p = 0.04), intrapartum cesarean section (9 [16.4 %] and 16 [6.6 %], p = 0.02), occiput-posterior variety at birth (20 [36.4 %] and 56 [22.9 %], p = 0.04), and brace umbilical positioning at birth (3 [5.4 %] and 2 [0.8 %], p = 0.04), respectively. There were no significant intergroup differences in terms of APGAR score, cord arterial pH/lactates, or reanimation/intensive care admission.
A successful ECV does not seem to guaranty an identical labor progress and obstetrical outcome as spontaneous cephalic presentations. Immediate neonatal state, on the other hand, seems unaffected by a history of ECV.
经阴道外倒转术（ECV）是一种将胎儿从臀位或横位转为头位的操作。我们的目的是评估 ECV 成功后的产科和即刻新生儿结局，与自发性头位分娩相对照。
我们进行了一项回顾性单中心观察性研究，时间为 2007 年 1 月至 2017 年 12 月。所有纳入的参与者均受益于试产并分娩为头位。他们根据 ECV 是否成功进行以及头位是否为自发性分为两组。
ECV 后头位组和自发性头位组分别有 55 例和 244 例患者。两组在诱导分娩的比例（20[36.4%]与 56[22.9%]，p=0.04）、分娩时使用催产素的比例（31[56.4%]与 100[49.9%]，p=0.04）、产程时间（342±183 分钟与 279±140 分钟，p=0.008）、自然分娩的比例（38[69.1%]与 199[81.5%]，p=0.04）、产时剖宫产的比例（9[16.4%]与 16[6.6%]，p=0.02）、分娩时枕后位的比例（20[36.4%]与 56[22.9%]，p=0.04）和出生时脐带位置异常的比例（3[5.4%]与 2[0.8%]，p=0.04）存在显著差异。两组新生儿 APGAR 评分、脐动脉 pH/乳酸值或复苏/重症监护入院率均无显著差异。
ECV 成功似乎不能保证与自发性头位分娩相同的产程进展和产科结局。另一方面，新生儿即刻状态似乎不受 ECV 病史的影响。
